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Patent ductus arteriosus in preterm newborns: A tertiary hospital experience
Institution:1. Faculty of Medicine of the Universidade do Porto, Portugal;2. Neonatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal;3. Pediatrics Department, Centro Hospitalar Universitário de São João, Porto, Portugal;4. Cardiovascular R&D Center, Faculty of Medicine University of Porto, Portugal
Abstract:IntroductionPatent ductus arteriosus (PDA) in preterm infants has been associated with increased mortality and comorbidities. This study aimed to characterize the population of preterm infants diagnosed with PDA and to identify predictive factors of response to medical treatment of PDA.MethodsAn eight-year retrospective observational study was carried out, which included all preterm infants with a gestational age (GA) between 23 and 32 weeks diagnosed with PDA, admitted to the Neonatal Unit of the CHUSJ. Univariate comparative analysis was performed, and models for predicting the effectiveness of PDA treatment with ibuprofen were explored by multivariate logistic regression analysis.Results115 cases were included and 34 were excluded, with a final sample of 81 preterm infants with PDA. The univariate analysis revealed significant differences in the closure efficacy via medical treatment with ibuprofen in several variables, and a multivariate logistic regression model was obtained (discriminative capacity 72.2%, sensitivity 98.1%, specificity 57.1%), taking into account the effect of GA, type of delivery, need for diuretics treatment and platelet transfusion.ConclusionThis study enabled the population of preterm infants diagnosed with PDA to be characterized and the identification of a predictive model that can help predict the efficacy of medical treatment and thus contribute to optimizing the medical approach to the non-responders.
Keywords:Preterm newborns  Patent ductus arteriosus  Ibuprofen  Recém-nascido-nascido pré-termo  Patência do canal arterial  Ibuprofeno
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